| NPI | 1043247117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 017836) |
| Additional Taxonomies | 174400000X Specialist (Licence: ME 9412) |
| 207P00000X Emergency Medicine (Licence: GA 017836) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2019-10-24 |